Person: GÜL, FETHİ
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GÜL
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FETHİ
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Publication Metadata only Terapötik Hipotermi Sonrası Gelişen Enfeksiyonların Öngörülmesinde Hematoloji Parametrelerinin Kullanımı(2017-10-29) HAKLAR, GONCAGÜL; GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; GÜL F., ÇEVLİK T., ARSLANTAŞ M. K., KASAPOĞLU U. S., HAKLAR G., CİNEL İ. H.Publication Open Access Abdominal perfusion pressure is superior from intra-abdominal pressure to detect deterioration of renal perfusion in critically Ill patients(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2019) GÜL, FETHİ; Gul, Fethi; Sayan, Ismet; Kasapoglu, Umut Sabri; Erol, Derya Ozer; Arslantas, Mustafa Kemal; Cinel, Ismail; Aykac, ZuhalBACKGROUND: Intra-abdominal hypertension (IAH) is a frequent cause of acute kidney injury (AKI) among critically ill patients who have risk factors. This study aimed to determine the relation between Abdominal Perfusion Pressure (APP) and AKI showed by the Doppler-based renal resistive index (RRI). METHODS: In this study, 38 patients older than 18 years old who received mechanical ventilation and had risk factors for the development of IAH were prospectively studied. All measurements and parameters were divided into two groups according to renal dysfunction (Group I: RRI <0.72 vs Group II: RRI >0.72). RESULTS: The mean IAPs were not significant between the groups, 11.5 +/- 6.9 mm Hg in Group I (n=35) and 13.5 +/- 5.8 in Group II (n=33), respectively. APPs were statistically higher in Group I (81.2 +/- 13.6) than Group II (66.4 +/- 9.5) (p<0.001). The AUC for the association between APP at RRI >0.72 was 0.802 (p<0.001), with the APP <= 72 mmHg having a sensitivity of the 76% (95% CI 58-89%) and a specificity of 71% (95% CI 54-85%). CONCLUSION: Our findings suggest that an APP with a threshold of <= 72 mmHg is associated with a significant increase in renal RRI, which may be predictive of worsening of renal perfusion.Publication Open Access Renal Resistive Index is Unsusceptible to Systemic Hemodynamics in Fluid Responsive Critically III Patients(GALENOS YAYINCILIK, 2019-11-12) BİLGİLİ, BELİZ; Gul, Fethi; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ayhan, Secil Ozcan; Cinel, IsmailObjective: The primary goal of fluid resuscitation in critically ill patients is to improve oxygen delivery to ensure adequate organ perfusion. Little evidence is known about renal response to fluids in the acute phase, so renal monitoring after the fluid challenge is fundamental during critical care stay. This study aimed to evaluate changes in the renal resistive index (RRI) and to compare these changes with hemodynamic parameters after fluid challenge in fluid responsive critically ill patients. Materials and Methods: Thirty patients older than 18 years who underwent sedation and received mechanical ventilation were prospectively studied. Twenty patients were fluid responsive and were included in the study. An increase of cardiac output (CO) by 10% or more after PLR measured by ultrasonic CO monitor suspected fluid responsiveness. 500 mL of isotonic solution was administered intravenously for 30 minutes. CO measurements were performed at 0, 1 and 30 minutes. RRI and mean arterial pressure (MAP) were measured by Doppler ultrasonography at 0 and 30 minutes. Repeated measures ANOVA method was used for statistical analysis and p<0.05 was considered significant. Results: CO increased significantly after fluid challenge when compared to baseline (from 3.48 +/- 1.14 to 4.34 +/- 1.43 L/min, p<0.001). MAP increased significantly after fluid administration when compared to baseline (80 +/- 19 to 86 +/- 17, p=0.002). RRI did not significantly differ from baseline after fluid challenge (62 +/- 9 to 60 +/- 10, p=0.11). There was a negative correlation between RRI and MAP at baseline and after fluid challenge. Conclusion: The effect of hemodynamic changes on renal perfusion after fluid challenge is controversial. In our study, 500 mL of crystalloid treatment for 30 minutes increased MAP and CO, but did not contribute to the improvement of RRI in patients who were fluid responsive. We found that fluid challenge did not improve RRI in the early phase of the fluid resuscitation in fluid responsive critically ill patients and RRI is unsusceptible to systemic hemodynamic changes during this period.Publication Metadata only Treatment approach of cerebral ischemia after revascularization surgery of moyamoya disease: Case report(2019-05-05) GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; GÜL F., KABADAYI F., KASAPOĞLU U. S., CİNEL İ. H.Publication Metadata only Lazer cerrahisi sırasında gelişen trakeobronşial inhalasyon yanığı- olgu sunumu(2017-10-29) KASAPOĞLU, UMUT SABRİ; GÜL, FETHİ; YUMUŞAKHUYLU, ALİ CEMAL; UMUROĞLU, TÜMAY; CİNEL, İSMAİL HAKKI; KASAPOĞLU U. S., GÜL F., ARSLANTAŞ M. K., YUMUŞAKHUYLU A. C., YAMANSAVCI E., UMUROĞLU T., CİNEL İ. H.Publication Metadata only Scatter-conductivity (VCS) parametres may predict infections and possible sepsis during therapeutic hypothermia(2017-05-13) GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HAKLAR, GONCAGÜL; GÜL F., ARSLANTAŞ M. K., ÇEVİK T., KASAPOĞLU U. S., HAKLAR G., CİNEL İ. H.Publication Metadata only Dental mesenchymal stem cells may have immunoregulatory effect on allorejection(2017-09-27) GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; AKKOÇ, TUNÇ; CİNEL, İSMAİL HAKKI; GÜL F., DOĞAN D., KASAPOĞLU U. S., AKKOÇ T., CİNEL İ. H.Publication Metadata only Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study(OXFORD UNIV PRESS, 2019) ERTÜRK ŞENGEL, BUKET; Arslan, Ferhat; Caskurlu, Hulya; Sari, Sema; Dal, Hayriye Cankar; Turan, Sema; Sengel, Buket Erturk; Gul, Fethi; Yesilbag, Zuhal; Eren, Gulay; Temel, Sahin; Alp, Emine; Serin, Basak Gol; Kose, Sukran; Calik, Sebnem; Tuncel, Zeki Tekgul; Senbayrak, Seniha; Sari, Ahmet; Karagoz, Gul; Tomruk, Senay Goksu; Sen, Betul; Hizarci, Burcu; Vahaboglu, HalukCandida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56-3.14); prior exposure to N-acetylcysteine, 0.11 (0.03-0.34) and prior surgical intervention, 1.26 (0.76-2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.Publication Metadata only A case of veno‐arterial extracorporeal membrane oxygenation for peripartum cardiomyopathy(2019-05-05) KASAPOĞLU, UMUT SABRİ; GÜL, FETHİ; CİNEL, İSMAİL HAKKI; KASAPOĞLU U. S., YİĞİT A. C., GÜL F., CİNEL İ. H.Publication Open Access Serum vitamin D level variation in SIRS, sepsis and septic shock(MARMARA UNIV, FAC MEDICINE, 2019-10-31) BİLGİLİ, BELİZ; Gul, Fethi; Arslantas, Mustafa K.; Bilgili, Beliz; Besir, Ahmet; Kasapoglu, Umut S.; Karakurt, Sait; Cinel, IsmailObjectives: Vitamin D has potent immunomodulatory effects with the capability of acting as an autocrine and paracrine agent, and inhibits inflammatory signaling. In this study, our aim was to evaluate the relationship between vitamin D levels in systemic inflammatory response syndrome (SIRS), sepsis and, septic shock patients and outcomes. Patients and Methods: A total of 45 patients whose vitamin D levels were measured within the first 48 hours of Intensive Care Unit (ICU) admission and 20 healthy controls were studied prospectively. The patients were grouped as, SIRS (Group-I,n=10), sepsis (Group-II, n=25), septic shock (Group-III, n -10) and healthy subjects (Group-IV, n=20). Serum vitamin D levels were categorized as a deficiency (<= 15ng/mL), insufficiency (16-29ng/mL) and sufficiency (>= 30ng/mL). Demographic characteristics, Acute Physiology and Chronic Health Assessment II (APACHE-II) scores, and biochemical parameters were noted. Results: Vitamin D levels were significantly lower in all study groups compared to the control group (p<0.01), but were similar among the study groups. The hospital and ICU length of stay (LOS), and biochemical parameters were similar among the study groups. The mortality rates were 40% in Group I, 57 % in Group II, and 80 % in Group III. Conclusion: In our study patients with SIRS, sepsis and septic shock had lower serum 25-OH vitamin D levels compared to the control group. Our results are in line with the literature that supports a relationship between vitamin D deficiency and inflammation.